Outreach Services

Updated 7 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were 2 registered managers in post.

Notice of inspection

The first day of this inspection was unannounced.

Inspection activity started on 10 May 2023 and ended on 30 May 2023. We visited the location’s office on 10 and 30 May 2023. We visited the location’s satellite office on 18 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Throughout our inspection we visited people and observed interactions between staff and people who used the service. We spoke directly with 4 people who used the service and 2 family members about their experience of the care provided. We also received written feedback from a further 2 relatives.

We spoke with 21 members of staff including the registered managers, members of the management and positive behaviour support team, the health and wellbeing lead and support workers.

We reviewed a range of records. This included 12 people’s care records and multiple medication records. We looked at 11 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 July 2023

About the service

Outreach Services is a domiciliary care service providing support and personal care to people who live in their own homes. The service provides support to autistic people and people with a learning disability. At the time of our inspection there were 224 people using the service who lived across a large geographical area within the Northwest of England.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

Many of the people who received support lived in 'supported living' settings. People held an individual tenancy for their own property or lived in shared accommodation where they held a tenancy for their bedroom; and shared communal areas such as lounges and kitchens. Each 'supported living' service had designated space for staff to store their belongings, maintain records and when needed, provide sleeping in support.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

The provider was working to transfer a small number of Autism Initiative owned properties into alternative ownership. This would then ensure all people who used the service were supported in a way which fully met the principles of 'Right support, right care, right culture'.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People had a choice in who supported them; staff knew people well and trusting relationships had been formed.

Staff supported people to take part in employment and education opportunities and to pursue their leisure interests in their local area. The provider demonstrated a commitment to offering opportunities for people to reduce the risk of people experiencing social isolation.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity, understanding and responding to their individual needs. People could communicate with staff and understood information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the registered managers and staff employed. People received good quality care and support and because appropriately trained staff could meet their needs and wishes. The provider had clear and effective governance systems in place which identified and managed risks through audits and action plans.

People receiving support, and those important to them, were involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 30 January 2018).

Why we inspected

The inspection was prompted in part due to concerns received about poor care, medicines and a lack of action by the management team to respond to concerns. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.